title: Quality of life during chemotherapy in lung cancer patients: results across different treatment lines.
abstract: BACKGROUND
  Most lung cancer patients are diagnosed at an advanced disease stage and predominantly receive palliative treatment, which increasingly consists of several chemotherapy lines. We report on patients' quality of life (QOL) to gain knowledge on QOL during and across multiple lines of chemotherapy. This includes patients with (neo)adjuvant therapy up to 3rd or above line palliative chemotherapy.
  
  
  METHODS
  Lung cancer patients receiving outpatient chemotherapy at the Kufstein County Hospital completed an electronic version of the EORTC QLQ-C30. Linear mixed models were used for statistical analysis.
  
  
  RESULTS
  One hundred and eighty seven patients were included in the study. Surprisingly, irrespective of the chemotherapy line patients reported stable QOL scores during treatment. None of the calculated monthly change rates attained clinical significance, referring to established guidelines that classify a small clinical meaningful change as 5 to 10 points. According to treatment line, 3rd or above line palliative chemotherapy was associated with the worst QOL scores, whereas patients undergoing (neo)adjuvant or 1st line palliative chemotherapy reported fairly comparable QOL.
  
  
  CONCLUSIONS
  The essential finding of our study is that all QOL aspects of the EORTC QLQ-C30 questionnaire remained unchanged during each chemotherapy line in an unselected population of lung cancer patients. Between treatment lines pronounced differences were found, indicating that later palliative chemotherapy lines are associated with higher QOL impairments. These changes in QOL may not primarily be related to the treatment, but rather refer to impairments due to disease progression and may be partly due to a consequence of the prior therapies.
authors.affiliation: Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria.
authors.forename: L M
authors.initials: LM
authors.lastname: Wintner
authors.forename: J M
authors.initials: JM
authors.lastname: Giesinger
authors.forename: A
authors.initials: A
authors.lastname: Zabernigg
authors.forename: M
authors.initials: M
authors.lastname: Sztankay
authors.forename: V
authors.initials: V
authors.lastname: Meraner
authors.forename: G
authors.initials: G
authors.lastname: Pall
authors.forename: W
authors.initials: W
authors.lastname: Hilbe
authors.forename: B
authors.initials: B
authors.lastname: Holzner
mesh_terms: D000368:Aged; D000553:Ambulatory Care; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D010166:Palliative Care / Q000379:methods; D011788:Quality of Life